NCCN Guidelines for Patients
Adolescents and Young Adults with Cancer, Version 1.2017
Infection and low white blood cells
Why it happens
Cancer itself and cancer treatment can put you at risk
for infection by lowering the number of white blood
cells (neutrophils). A severe drop in the neutrophils is
known as neutropenia. These white blood cells help
you fight infection. An infection is caused by germs
like bacteria, viruses, or fungi that enter the body and
grow out of control. Other things like lack of sleep,
stress, and poor diet can also lower your immune
system’s ability to fight an infection.
What you can do
Be aware of what your body is feeling. Frustrating
though it may be, you really need to protect yourself
from germs that your system just isn’t ready to fight.
After all, the last thing you need while battling cancer
is a severe case of the flu. Below are things you can
do to protect yourself.
Buy a good thermometer. Taking your
temperature can help find infections before
they get serious.
When your counts are at their lowest, stay
away from young children or sick people. Tell
people to be extra careful about hand washing
and covering their sneezes and coughs
Wash your hands. Carry hand sanitizer and
try to use it whenever you touch certain
surfaces like doorknobs. You may want to
avoid shaking people’s hands.
Avoid salad bars and buffets.
Ask friends and family to stay away if they’re
feeling sick, or if they’ve been around a sick
If your white blood cell count is low, ask your
doctor if you should stay home from work
or school. If you can’t stay home, be sure to
wash your hands often.
Get a flu shot every Fall. Talk about when you
should get the shot with your treatment team.
Nerve damage (neuropathy)
Why it happens
Many common chemotherapy drugs can cause
damage to nerve cells that affect normal nerve
signals (neuropathy). Peripheral neuropathy affects
the hands and feet and can begin as sensitivity to
cold, pain, burning, and numbness. It is also said to
cause that feeling of “pins and needles."
Neuropathy can also affect nerves in the ear, leading
to hearing loss, ringing in the ears, and problems
with balance and coordination. Central neuropathy
can cause problems with concentration and memory
that are common in people receiving chemotherapy
Neuropathy usually stops once treatment is over, but
sometimes the neuropathy does not go away. Your
treatment team will want watch for these side effects
What you can do
Your treatment team may try to limit your risk by
reducing or skipping one or more doses of a cancer
drug that cause neuropathy
If you have neuropathy, there is medicine and
complementary therapies you can use:
Doctors can prescribe medicine like
gabapentin—a drug to prevent convulsions—
can ease the symptoms of peripheral
Antidepressants such as amitriptyline and
venlafaxine can alter the level of brain
chemicals that control pain signals.
Over-the-counter pain relievers such as
acetaminophen and ibuprofen can relieve the
pain of neuropathy.
Things like acupuncture, massage, and
physical therapy can help as well.
Coping with side effects
How do I cope with side effects?